Ventilation during COVID-19 in a school for students with intellectual and developmental disabilities (IDD).

BACKGROUND: This study examined the correlation of classroom ventilation (air exchanges per hour (ACH)) and exposure to CO2 ≥1,000 ppm with the incidence of SARS-CoV-2 over a 20-month period in a specialized school for students with intellectual and developmental disabilities (IDD). These students were at a higher risk of respiratory infection from SARS-CoV-2 due to challenges in tolerating mitigation measures (e.g. masking). One in-school measure proposed to help mitigate the risk of SARS-CoV-2 infection in schools is increased ventilation. METHODS: We established a community-engaged research partnership between the University of Rochester and the Mary Cariola Center school for students with IDD. Ambient CO2 levels were measured in 100 school rooms, and air changes per hour (ACH) were calculated. The number of SARS-CoV-2 cases for each room was collected over 20 months. RESULTS: 97% of rooms had an estimated ACH ≤4.0, with 7% having CO2 levels ≥2,000 ppm for up to 3 hours per school day. A statistically significant correlation was found between the time that a room had CO2 levels ≥1,000 ppm and SARS-CoV-2 PCR tests normalized to room occupancy, accounting for 43% of the variance. No statistically significant correlation was found for room ACH and per-room SARS-CoV-2 cases. Rooms with ventilation systems using MERV-13 filters had lower SARS-CoV-2-positive PCR counts. These findings led to ongoing efforts to upgrade the ventilation systems in this community-engaged research project. CONCLUSIONS: There was a statistically significant correlation between the total time of room CO2 concentrations ≥1,000 and SARS-CoV-2 cases in an IDD school. Merv-13 filters appear to decrease the incidence of SARS-CoV-2 infection. This research partnership identified areas for improving in-school ventilation.

3D multi-robot olfaction in naturally ventilated indoor environments: Locating a time-varying source at unknown heights.

Source localization is significant for mitigating indoor air pollution and safeguarding the well-being and safety of occupants. While most study focuses on mechanical ventilation and static sources, this study explores the less-explored domain of locating time-varying sources in naturally ventilated spaces. We have developed an innovative 3D localization system that adjusts to varying heights, significantly enhancing capabilities beyond traditional fixed-height 2D systems. To ensure consistency in experimental conditions, we conducted comparative analyses of 2D and 3D methods, using a swinging fan to simulate natural ventilation. Our findings reveal a substantial disparity in performance: the 2D method had a success rate below 46.7% in cases of height mismatches, while our 3D methods consistently achieved success rates above 66.7%, demonstrating their superior effectiveness in complex environments. Furthermore, we validated the 3D strategies in real naturally ventilated settings, confirming their wider applicability. This research extends the scope of indoor source localization and offers valuable insights and strategies for more effective pollution control.

Review of the research status on the transmission and diffusion characteristics of indoor viral aerosol particles.

This study reviews the generation and diffusion characteristics of indoor viral aerosol particles, numerical simulation methods for the diffusion process of viral aerosols, and related research on the impact mechanism of different ventilation methods on the diffusion process of viral aerosols. Research has shown that the selection of initial conditions such as exhalation mode, initial airflow velocity, particle size, turbulence model, and calculation method for the generation of aerosol particles by the human body is of great significance for the numerical simulation of the diffusion process of viral aerosol particles. At the same time, on the basis of selecting appropriate ventilation methods, the reasonable setting of ventilation parameters (temperature, speed, height, etc.) can effectively suppress the spread of viral aerosols. This study can provide a theoretical basis for the study of related respiratory diseases, as well as technical and theoretical support for the selection of indoor ventilation methods to reduce the risk of human exposure caused by viral aerosols in the construction field. It also provides guidance and reference for aerosol transport and environmental protection in indoor atmospheric environments.

The multi-dimensional challenges of controlling respiratory virus transmission in indoor spaces: Insights from the linkage of a microscopic pedestrian simulation and SARS-CoV-2 transmission model.

SARS-CoV-2 transmission in indoor spaces, where most infection events occur, depends on the types and duration of human interactions, among others. Understanding how these human behaviours interface with virus characteristics to drive pathogen transmission and dictate the outcomes of non-pharmaceutical interventions is important for the informed and safe use of indoor spaces. To better understand these complex interactions, we developed the Pedestrian Dynamics-Virus Spread model (PeDViS), an individual-based model that combines pedestrian behaviour models with virus spread models incorporating direct and indirect transmission routes. We explored the relationships between virus exposure and the duration, distance, respiratory behaviour, and environment in which interactions between infected and uninfected individuals took place and compared this to benchmark 'at risk' interactions (1.5 metres for 15 minutes). When considering aerosol transmission, individuals adhering to distancing measures may be at risk due to the buildup of airborne virus in the environment when infected individuals spend prolonged time indoors. In our restaurant case, guests seated at tables near infected individuals were at limited risk of infection but could, particularly in poorly ventilated places, experience risks that surpass that of benchmark interactions. Combining interventions that target different transmission routes can aid in accumulating impact, for instance by combining ventilation with face masks. The impact of such combined interventions depends on the relative importance of transmission routes, which is hard to disentangle and highly context dependent. This uncertainty should be considered when assessing transmission risks upon different types of human interactions in indoor spaces. We illustrated the multi-dimensionality of indoor SARS-CoV-2 transmission that emerges from the interplay of human behaviour and the spread of respiratory viruses. A modelling strategy that incorporates this in risk assessments can help inform policy makers and citizens on the safe use of indoor spaces with varying inter-human interactions.

Theoretical Threshold for Estimating the Impact of Ventilation on Materials' Emissions.

In new buildings, nonoccupant VOC emissions are initially high but typically decrease within months. Increased ventilation is commonly used to improve indoor air quality, assuming it speeds up VOC off-gassing from materials. However, previous research presents inconsistent results. This review introduces a simplified analytical model to understand the ventilation-emission relationship. By combining factors such as diffusivity, emitting area, and time, the model suggests the existence of a theoretical ventilation threshold beyond which enhanced ventilation has no further influence on emission rates. A threshold of approximately 0.13 L s-1 m-2 emitting area has been found for various VOCs documented in the existing literature, with which the conflicting results are explained. It is also shown that the threshold remains notably consistent across different boundary conditions and model resolutions, indicating its suitability for real-world applications.

Numerical performance of CO2 accumulation and droplet dispersion from a cough inside a hospital lift under different ventilation strategies.

The impact of mechanical ventilation on airborne diseases is not completely known. The recent pandemic of COVID-19 clearly showed that additional investigations are necessary. The use of computational tools is an advantage that needs to be included in the study of designing safe places. The current study focused on a hospital lift where two subjects were included: a healthy passenger and an infected one. The elevator was modelled with a fan placed on the middle of the ceiling and racks for supplying air at the bottom of the lateral wall. Three ventilation strategies were evaluated: a without ventilation case, an upwards-blowing exhausting fan case and a downwards-blowing fan case. Five seconds after the elevator journey began, the infected person coughed. For the risk assessment, the CO2 concentration, droplet removal performance and dispersion were examined and compared among the three cases. The results revealed some discrepancies in the selection of an optimal ventilation strategy. Depending on the evaluated parameter, downward-ventilation fan or no ventilation strategy could be the most appropriate approach.

Influence of Ventilation on Formation and Growth of 1-20 nm Particles via Ozone-Human Chemistry.

Ozone reaction with human surfaces is an important source of ultrafine particles indoors. However, 1-20 nm particles generated from ozone-human chemistry, which mark the first step of particle formation and growth, remain understudied. Ventilation and indoor air movement could have important implications for these processes. Therefore, in a controlled-climate chamber, we measured ultrafine particles initiated from ozone-human chemistry and their dependence on the air change rate (ACR, 0.5, 1.5, and 3 h-1) and operation of mixing fans (on and off). Concurrently, we measured volatile organic compounds (VOCs) and explored the correlation between particles and gas-phase products. At 25-30 ppb ozone levels, humans generated 0.2-7.7 × 1012 of 1-3 nm, 0-7.2 × 1012 of 3-10 nm, and 0-1.3 × 1012 of 10-20 nm particles per person per hour depending on the ACR and mixing fan operation. Size-dependent particle growth and formation rates increased with higher ACR. The operation of mixing fans suppressed the particle formation and growth, owing to enhanced surface deposition of the newly formed particles and their precursors. Correlation analyses revealed complex interactions between the particles and VOCs initiated by ozone-human chemistry. The results imply that ventilation and indoor air movement may have a more significant influence on particle dynamics and fate relative to indoor chemistry.

Zonal demand-controlled ventilation strategy to minimize infection probability and energy consumption: A coordinated control based on occupant detection.

Due to the outbreak of COVID-19, an increased risk of airborne transmission has been experienced in buildings, particularly in confined public places. The need for ventilation as a means of infection prevention has become more pronounced given that some basic precautions (like wearing masks) are no longer mandatory. However, ventilating the space as a whole (e.g., using a unified ventilation rate) may lead to situations where there is either insufficient or excessive ventilation in localized areas, potentially resulting in localized virus accumulation or large energy consumption. It is of urgent need to investigate real-time control of ventilation systems based on local demands of the occupants to strike a balance between infection risk and energy saving. In this work, a zonal demand-controlled ventilation (ZDCV) strategy was proposed to optimize the ventilation rates in sub-zones. A camera-based occupant detection method was developed to detect occupants (with eight possible locations in sub-zones denoted as 'A' to 'H'). Linear ventilation model (LVM), dimension reduction, and artificial neural network (ANN) were integrated for rapid prediction of pollutant concentrations in sub-zones with the identified occupants and ventilation rates as inputs. Coordinated ventilation effects between sub-zones were optimized to improve infection prevention and energy savings. Results showed that rapid prediction models achieved an average prediction error of 6 ppm for CO2 concentration fields compared with the simulation under different occupant scenarios (i.e., occupant locations at ABH, ABCFH, and ABCDEFH). ZDCV largely reduced the infection risk to 2.8% while improved energy-saving efficiency by 34% compared with the system using constant ventilation rate. This work can contribute to the development of building environmental control systems in terms of pollutant removal, infection prevention, and energy sustainability.

Study on infection risk in a negative pressure ward under different fresh airflow patterns based on a radiation air conditioning system.

COVID-19 and other respiratory infectious viruses are highly contagious, and patients need to be treated in negative pressure wards. At present, many negative pressure wards use independent air conditioning equipment, but independent air conditioning equipment has problems such as indoor air circulation flow, condensate water accumulation, and improper filter maintenance, which increase the risk of infection for healthcare workers and patients. The radiation air conditioning system relies on the radiation ceiling to control the indoor temperature and uses new air to control the indoor humidity and air quality. The problems caused by the use of independent air conditioning equipment should be avoided. This paper studies the thermal comfort, contaminant distribution characteristics, contaminant removal efficiency, and accessibility of supply air in a negative pressure ward with a radiation air conditioning system under three airflow patterns. In addition, the negative pressure ward was divided into 12 areas, and the infection probability of healthcare workers in different areas was analyzed. The results show that the application of radiation air conditioning systems in negative pressure wards can ensure the thermal comfort of patients. Stratum ventilation and ceiling-attached jets have similar effects in protecting healthcare workers; both can effectively reduce the contaminant concentrations and the risk of infection of healthcare workers. Ceiling-attached jets decreases the contaminant concentrations by 10.73%, increases the contaminant removal efficiency by 12.50%, and decreases the infection probability of healthcare workers staying indoors for 10 min by 23.18%, compared with downward ventilation.

Long-term prediction of the effects of climate change on indoor climate and air quality.

Limiting the negative impact of climate change on nature and humans is one of the most pressing issues of the 21st century. Meanwhile, people in modern society spend most of the day indoors. It is therefore surprising that comparatively little attention has been paid to indoor human exposure in relation to climate change. Heat action plans have now been designed in many regions to protect people from thermal stress in their private homes and in public buildings. However, in order to be able to plan effectively for the future, reliable information is required about the long-term effects of climate change on indoor air quality and climate. The Indoor Air Quality Climate Change (IAQCC) model is an expediant tool for estimating the influence of climate change on indoor air quality. The model follows a holistic approach in which building physics, emissions, chemical reactions, mold growth and exposure are combined with the fundamental parameters of temperature and humidity. The features of the model have already been presented in an earlier publication, and it is now used for the expected climatic conditions in Central Europe, taking into account various shared socioeconomic pathway (SSP) scenarios up to the year 2100. For the test house examined in this study, the concentrations of pollutants in the indoor air will continue to rise. At the same time, the risk of mold growth also increases (the mold index rose from 0 to 4 in the worst case for very sensitive material). The biggest problem, however, is protection against heat and humidity. Massive structural improvements are needed here, including insulation, ventilation, and direct sun protection. Otherwise, the occupants will be exposed to increasing thermal discomfort, which can also lead to severe heat stress indoors.

Holistic understanding of ventilation rate in occupational health risk control.

Throughout the history of occupational health risk control, ventilation has been implemented widely as a tried-and-true method to reduce exposure intensity to airborne contaminants. Proper determination of the ventilation rate merits careful consideration when addressing concerns directed toward occupational health and indoor air quality in commercial buildings, albeit this does not translate well among the current engineering and scientific community. This article aims to facilitate a better understanding and proper determination of ventilation rates as a countermeasure for occupational health risk control. To that end, guidance is provided to select the appropriate ventilation rate for nonpandemic versus pandemic scenarios in terms of pertinent regulatory/professional codes and mathematical modeling tools. Limitations and assumptions of the models are summarized to facilitate proper application. Furthermore, the emerging DNA-based aerosol tracing technology, which helps to verify ventilation efficacy, is discussed.

Do Saliva-Saturated Spit Hoods Interfere With Ventilation?

ABSTRACT: Spit hoods are used by law enforcement, officers in correctional facilities, and medical personnel during the restraint of agitated subjects that are actively spitting to prevent the transmission of droplet-transmitted pathogens. We could find no studies reporting on the time course of normal breathing to clear saliva from such a saturated spit hood. We purchased samples of 3 popular spit hood models and applied a section over the output of a pneumatic test system. We used a digital anemometer, digital manometer, and an inline controllable fan for back pressure and flow. The pressure was 3 mm Hg to match quiet breathing. The tested area was saturated with artificial saliva, and air pressure was applied while we recorded the pressure and airflow. Within 5 seconds, the spit hoods all cleared sufficient artificial saliva to allow 1 m/s of airflow, which exceeds that of an N95 mask with similar pressure. Commonly used spit hoods offer very low resistance to breathing even after being initially saturated with artificial saliva. Our results do not support the hypothesis that a saliva-filled spit hood might contribute to death.

Modeling and identification of the hygro-thermal parameters of mechanically-ventilated broiler house using prediction error: Assessment in cold conditions.

Indoor air temperature and humidity moisture are of the foremost significance in climate control of broilers houses, and their impacts on poultry health and production depend on accurate control. The main objective of this work is to identify and assess a novel state-space model, to rapidly predict the hygro-thermal behavior of the livestock building. To achieve this analysis, various experimental measurements (e.g., ventilation rate, thermal heating, and air temperature and humidity) of two commercial poultry houses placed in the Mediterranean zone were monitored over cold conditions production cycle. The developed model was estimated and validated against a dataset of 25 days acquired under three different operation ventilation modes (min-ven, power and tunnel modes). Through simulation, the results showed that the predicted model and measured data were achieved a satisfactory accuracy with an averaged coefficients of determination R2 were 0.93 and 0.95, respectively, for the indoor air temperature and humidity models, and a root mean squared error (RMSE) of 0.3213 °C and 0.957 %. Additionally, the predictive model shows satisfying performances for the long horizon prediction with a final prediction error (FPE) equal to 0.084, which will prevent the intensely time-consuming process of getting precise physical parameters in regards the poultry house system.

Clinical Issues - January 2024.

Off-label medication use and prescribing practices Key words: off-label, licensed prescriber, approved, unapproved, US Food and Drug Administration (FDA). Prophylactic, therapeutic, and empiric use of antimicrobial agents Key words: prophylactic, therapeutic, empiric, infection, antimicrobial. Perioperative RN administration of antineoplastic agents Key words: antineoplastic medication, chemotherapy, hyperthermic intraperitoneal chemotherapy (HIPEC), instillation device, perfusionist. Minimum efficiency reporting values, parameters, and testing for air filters in heating, ventilation, and air-conditioning systems Key words: heating, ventilation, and air-conditioning (HVAC); minimum efficiency reporting value (MERV); particle size removal efficiency; air filter; filtration.

Guidelines in Practice: Design and Maintenance of the Surgical Suite.

Hospital construction and renovation is an ongoing occurrence in the health care setting. The recently updated AORN "Guideline for design and maintenance of the surgical suite" provides perioperative nurses with information on the layout design and maintenance of perioperative spaces; safety measures to use during construction and renovation; monitoring and maintenance of the heating, ventilation, and air conditioning; and how to respond to unintended utility failures. This article provides an overview of the guideline and discusses recommendations for the interdisciplinary team, planning and designing the surgical suite, construction-related environmental contamination, ORs, and OR maintenance. It also includes a scenario describing specific concerns associated with the construction of an additional OR. Perioperative nurses should review the guideline in its entirety and apply the recommendations when participating in perioperative construction and renovation projects.

Optimizing indoor air quality: CFD simulation and novel air cleaning methods for effective aerosol particle inhibition in public spaces.

In contemporary building ventilation, displacement and mixing ventilation demand high air volumes for rapid virus elimination, resulting in elevated energy consumption. To minimize the spread of viruses and decrease energy consumption for ventilation, this study employed CFD to explore the efficacy of a downward uniform flow field in impeding the transmission of aerosol particles in a high-traffic public facility, like a supermarket. The findings indicate that the downward uniform flow field proves insufficient when individuals remain static for extended periods. A wind speed of 0.1 m/s or higher becomes essential to overpower the stationary thermal plume, which disrupts this flow field. In areas with human presence, however, this technique is found to be particularly efficient since mobile heat sources do not generate a fixed thermal plume. A 0.05 m/s downward uniform flow field can settle 90% of particles within just 22 s. This flow pattern contributes to the swift settling of aerosol particles and effectively diminishes their dispersion. Employing this flow pattern in public places with increased foot traffic, like supermarkets, can lower the risk of contracting novel coronavirus without augmenting energy consumption. In order to implement the flow field in a part of the domain, a new air purification device is proposed in this study. The device combined with shelves can optimize the flow field uniformity through the MLA (PSO-SVR) algorithm and alteration of the air distribution structure. The uniformity of the final flow field increased to 0.925. The combination of data-driven MLA with CFD showed good performance in predicting the flow field uniformity. These findings offer valuable insights and practical applications for the prevention and control of respiratory diseases, particularly in post-epidemic scenarios.

A new chapter of healthy indoor air: antiviral air treatments.

Aerosol transmission remains a major challenge for the control of respiratory viruses. To date, prevention strategies include masks, vaccinations, physical distancing, travel restrictions, and lockdowns. Such measures are effective but come with heavy societal burdens and rely on public compliance. Additionally, most are simply not suitable as long-term measures. Other strategies evolve around the concept of improved indoor air quality and involve ventilation, relative humidity (RH) control, and air filtration. Unfortunately, natural ventilation increases exposure to airborne pollutants and vector-borne diseases, and incurs substantial energy losses in colder months. Mechanical ventilation concepts, including regular air changes and filtration, are effective but costly, and often require expensive engineering solutions and widespread renovations. Alternative options to reduce the spread of emerging and seasonal infections are sorely needed. In this issue of EMBO Molecular Medicine, Styles et al (2023) describe the use of propylene glycol (PG) to inactivate infectious bioaerosols and virus-containing droplets deposited on surfaces.

Optimization of cabin seating arrangement strategies based on the Wells-Riley risk theory.

Civil aviation transport is an important source of global respiratory disease spread due to the closely-spaced environment. In order to reduce the probability of infection of passengers, an improved Wells-Riley model for cabin passenger risk assessment have been given in this work, the cabin ventilation and passenger nose and mouth orientation were considered. The model's effectiveness has been verified with published data. Finally, how the load factor and use of an empty seat scheme are associated with the number of infected people was assessed. The results demonstrated that the number of infected people positively correlates with the passenger load factor, and the most suitable load factor can be determined by controlling the final number of infected people with the condition of the epidemic situation in the departure city. Additionally, infection risk was found to be lower among passengers in window seats than in those in aisle seats and middle seats, and keeping empty seats in the middle or aisle could reduce the cabin average probability of infection by up to 37.47%. Using the model developed here, airlines can determine the optimal load factor threshold and seating arrangement strategy to improve economic benefits and reduce the probability of passenger infection.

Perspectives on human movement considerations in indoor airflow assessment: a comprehensive data-driven systematic review.

Understanding particle dispersion characteristics in indoor environments is crucial for revising infection prevention guidelines through optimized engineering control. The secondary wake flow induced by human movements can disrupt the local airflow field, which enhances particle dispersion within indoor spaces. Over the years, researchers have explored the impact of human movement on indoor air quality (IAQ) and identified noteworthy findings. However, there is a lack of a comprehensive review that systematically synthesizes and summarizes the research in this field. This paper aims to fill that gap by providing an overview of the topic and shedding light on emerging areas. Through a systematic review of relevant articles from the Web of Science database, the study findings reveal an emerging trend and current research gaps on the topic titled Impact of Human Movement in Indoor Airflow (HMIA). As an overview, this paper explores the effect of human movement on human microenvironments and particle resuspension in indoor environments. It delves into the currently available methods for assessing the HMIA and proposes the integration of IoT sensors for potential indoor airflow monitoring. The present study also emphasizes incorporating human movement into ventilation studies to achieve more realistic predictions and yield more practical measures. This review advances knowledge and holds significant implications for scientific and public communities. It identifies future research directions and facilitates the development of effective ventilation strategies to enhance indoor environments and safeguard public health.

Quantitative Microbial Risk Assessment for Quantification of the Effects of Ultraviolet Germicidal Irradiation on COVID-19 Transmission.

Quantitative microbial risk assessment (QMRA) is presented as a tool for evaluation of the effectiveness of ultraviolet germicidal irradiation (UVGI) systems for the disinfection of indoor air. The QMRA is developed in the context of UVGI system implementation for control of SARS-CoV-2 infection and comprises submodels to address problem formulation, exposure assessment, and health effects assessment, all of which provide input to a risk characterization submodel. The model simulations indicate that UVGI systems can effectively control the risk of infection associated with SARS-CoV-2 for low to moderate virus emission rates. The risk of disease transmission is strongly influenced by the rate of pathogen emission by an infected individual, the output power of UVGI fixtures and their configuration, the source of UV-C radiation implemented in the UVGI fixtures, and the characteristics of the heating, ventilation, and air conditioning (HVAC) system. The QMRA framework provides a quantitative link between UVGI/HVAC system characteristics and changes in the risk of disease transmission. The framework can be adapted to other airborne pathogens and provides a rational basis for the design, testing, and validation of UVGI systems.